
MS\ 



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YELLOW FEVER 

AND ITS 

TREATMENT 

BY S. pAjHLEIN, M. D. 







YELLOW FEVER 



AND II 



TREATMENT. 



NEW AND SUCCESSFUL PLAN 



STEPHEN P. UHLEIN, M. D. 



OF 



STARKE, 
BRADFORD COUNTY, FLORIDA. 



Copyright, 1887, by Stephen P. Fheein, M. D. 



I 




PALATKA, FLORIDA : 
PRINTED BY THE NEWS PUBLISHING CO. 

1887. 



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<*<** 



PREFACE. 



Having been successful in the treatment of 
thirty-one cases of pernicious Malarial Fever, or 
more commonly known by the name of Yellow 
Fever, that had all the features of the disease, as 
it prevailed in Jacksonville, Florida, in the months 
of August, September and October, of L877, I 
thought proper I should make known to the pro- 
fession and the public my course and plan of treat- 
ment used and followed out at that time, believing 
it to be a humane act, though with some hesitancy, 
on the ground that some of my medical brethren, 
who have had experience in the treatment of this 
disease, may entertain doubt that thirty-one case 
should have been treated without one death. 
However, let this be as it may, the facts as above 
stated are true. 

Following are the testimonials of two of the 
thirty-one cases successfully treated in Jackson- 
ville at that time : 

In October. 1877, when an epidemic of Yellow 
Fever prevailed in Jacksonville, myself and wife 
w T ere attacked with disease. Dr. S. P. Uhlein, 
who was a practising physician in the city at the 
time, was called in, and under his skillful treat- 
ment Ave were soon restored to perfect health. In 
the same house where we boarded there were 
three other cases, all of which Dr. Uhlein treated 
with complete success. 

During the prevalence of the epidemic he treated 
to my knowledge from fifty to seventy-five cases 
of malignant malarial and Yellow Fever, without 
losing a single patient, while other physicians 
under different treatment were loosing numbers 
daily. M. I. Coxe, Palatka, Fla. 






YELLOW FEVER 

\M> IT> 

TREATMENT. 



It is not my objecl (in the main), in tin's work or 
treatise on Yellow Fever, to enter into any discus- 
sion as to the contagiousness or non-contagious- 
ness of the disease, or as to its cause or supposed 

cause ; but to present a more rational, definite and 

successful plan of treatment to the public and 
profession than lias hitherto been made known by 
any ^\' our authors on the subject. 

Yellow Fever is a disease that prevails in warm 
climates, or Southern latitudes, and originates 
from a specific cause, malaria] in character, being 
developed in the highest degree of intensity from 
decomposition of organic matter. And in corrob- 
oration of this view, Dr. Hamilton, as quoted by 
Dr. Roberts (page 239, " Roberts' Practice "), says 
thai " bellow Fever is the highest development of a 
group of diseases which appears to be in some way 
connected with, or dependent on. organic decom- 
position." The cause of this disease is generated 
in low marshy places, along the hanks <)( rivers, 
by insufficient drainage, by decay of tilth <>r veget- 
able mattei-, under certain degrees of heat or tem- 
perature, and other circumstances peculiar to 
Southern latitude-. 



And when we come to examine into the features 
of this disease, its nature and character, we can 
then more readily understand it, and we will then 
be better prepared to treat it successfully. As we 
have already mentioned, this disease has a specific 
cause, as well as most other affections, such as 
small pox and scarlet fever, typhoid and typhus 
fevers. The poison in these affections being ab- 
sorbed into the blood, through the lungs, becomes 
contaminated or diseased, which has different 
effects on the system, according to the nature of 
the poison absorbed. Whatever may be the fea- 
tures of this poison absorbed, whether in the shape 
of parasites or spores, it is evident that its force is 
first spent primarily on the blood — secondarily, on 
the liver, portal circulation and the nervous system. 

Some of the most prominent symptoms first ob- 
served is a peculiar cold sensation along the spine, 
coldness of the extremities, chilly sensations, se- 
vere headache, stiffness of the neck, pain in the 
back and limbs, accompanied in some cases with 
jerking of the muscles of the lower extremities, 
and sometimes coma and unconsciousness ; also a 
sensation of weight in the epigastric region, with 
nausea and tendency to vomiting. And when 
vomiting does occur in malignant and violent 
cases, its appearance is of a dark color. Nothing 
but a poison extremely virulent in its nature 
generated to its highest intensity, could produce 
symptoms of such a grave character as those al- 
ready mentioned. The poison so absorbed into 
the system generates a diseased state of the blood. 

The peculiar poison that develops typhoid, or 
gastro-enteric. fever — the lesion is found in ulcer- 



n of pi gland and irrital ion of I he tntf- 

cus membrane of the Btomach and intestinal 
canal. Thai poison thai develops cerebro spinal 
meningitis the force of the disease is spenl on the 
membranes of the brain and spinal cord. The poi 
Bon peculiar to small pox in thai disease its de 
velopmenl is upon the skin. So in scarlel fever 
and all other eruptive diseases the poison peculiar 
to each one develops its own symptoms. So with 
Yellow Fever having a specific <>r peculiar poison 
of its own, it develops a diseased or congested con- 
dition of the liver, portal circulation, gastric veins, 
and more or less disturbance of the brain and 
spinal cord, affecting it in a more or less degree in 
a certain manner. 

The natural tendency in all malarial affections, 
and almost all other diseases in warm climates, i> 
to develop congestion in one or more organs of 
the body. And this is particularly true in a 
marked <t< j </n j r in eases of so-called Yellow Fever. 
One of the pathological conditions of this disease 
is extreme congestion of the liver, portal circula- 
tion, gastric veins, and in many cases the base of 
the brain and portions of the spinal cord, and a 
toxic influence on the brain. These arc the parts 
most affected in cases of Yellow Fever, viz. : or to 
repeat, liver, portal circulation, gastric veins,axkd 
a toxic influence on the brain. These organs being 
in a congested state, gives rise to coldness of the 
surface of the body and extremities the blood 
being determined to the internal organs. The 

toxic condition of the brain e;ives rise to conges- 
tion and coma hence in many instances uncon- 
usness. delirium and sudden death. 



In tin 4 treatment of this disease, if anything can 

be done to neutralize this poison, or cause, it will 
certainly arrest the progress of the disease, and a 
great point will be gained. If the poison or cause 
of the disease is removed it will then only remain 
to relieve and rem< ve the abnormal cenditions of 
the organs affected. In cases of the bite of an in- 
sect or snake, or other poison, we administer an 
antidote to neutralize the poison — in some instances 
there may be no known antidote — in such cases the 
poison may be removed by elimination, by acting 
upon the bowels, kidneys and skin. Now the 
remedies best adapted for the successful treatment 
of Yellow Fever act both by elimination and neu- 
tralization, to remove the cause. The natural ten- 
dency in this affection, when the poison is viru- 
lent, is to produce disorganization of the blood. It 
then becomes thin and watery, losing its vitality, 
and the patient must succumb. Such is the case 
when the disease prevails as an epidemic, unless 
prevented by suitable remedies. 

I may state here that patients that die of this 
pernicious malarial fever die from one of two 
causes — either from congestion or from disorgani- 
zation of the blood. Whenever an organ is con- 
gested to any great degree the function of that or- 
gan is temporarily suspended. For instance, 
when the kidneys are congested, they cease in a 
measure to perform their function. When the 
brain is congested, the system does not readily re- 
spond to remedies then given. When the liver is 
congested, which is extremely so in cases of Yel- 
low Fever, the function of this organ is suspended ; 
hence the yellow appearance of the skin of pa- 
tients when there liver is in this condition. 



M\ object in these illustrations here given fa to 
show that the yellowness of the skin thai occur 
in this fever is caused by the suspension of the 
function of the liver, in consequence of its being 
in a congested state. Consequently this billious 

principle thai is usually secreted in health g068 On 

its rounds through the circulation, showing itself 

upon the skin. Or when it may he partialis or 

fully secreted, the flow of bile may be obstructed 
in the gall ducts, through coagulated blood from 
excessive engorgement of the blood vessels and 
capillaries therefore the mixture of bile and blood 

that is often seen in fluids vomited in this disease 
is readily accounted for. 

Black Vomit a Conservative Effort ok Na- 
ture. — This is especially True in 
its First Stage. 

In reference to black vomit, I would say thai 
this condition of the blood vessels and capillaries, 
already described, also is explanatory of the cause 
of black vomit and the manner it is brought about. 
The blood vessels and capillaries being in this en- 
gorged and congested state, give way ; and conse- 
quently there is more or less hemorrhage, and the 
blood itself mixing with the gastric juices and 
fluids of the stomach is then vomited, and is of a 
dark grunious color. 

Although this kind of vomiting is frightening 
in its appearance, it is not necessarily a fatal 
Bymptom (although a grave one), from the reason 
that in the first stage it is merely produced by this 
engorged state of the blood vessels and capillaries; 
and in the latter stages the tendency may he en- 
hanced or increased by this blood tendency to dis- 



s 

organization. For. indeed, the first condition is 
readily removed by relieving the congested blood 
vessels, and the second condition avoided or pre- 
vented by neutralizing the blood poison, which is 
the cause of disorganization. For both of ///esc 
conditions I am happy to say we have remedies 
that act promptly and successfully. * 

Treatment. 

According to the views I entertained and ad- 
vanced in my remarks on the nature and theory 
of this pernicious malarial disease (more common- 
ly called Yellow Fever), it seems to me the indi- 
cations to be followed out in its treatment are 
plain and simple — as it prevailed in Jacksonville 
in the months of August, September and October, 
1877, and in other parts of the State. 

The remedies used consisted in the main of an- 
tiseptics or antidotes, cathartics, hepatics and 
revulsives. I usually commenced at once with a 
free use of the antidote in large doses. By so doing 
you strike at once at tfye root or cause of the dis- 
ease. This medicine is calculated to neutralize, 
kill or destroy the poison that produces the dis- 
ease. At least such seems to be its effect, whether 
it be in the shape of spore, animalculae or parasites. 

After the administration of this article in doses 
of from one-quarter teacupfull to children, or one 
teacupful to adults, every two or three hours — 
without which you cannot expect a cure — I usu- 
ally applied sinapisms, in the shape of mustard 
plasters, over the region of the stomach, also must- 
ard over the whole length of the spine* — hot bath 

* In severe eases it would be advisable to put the patient in a hot bath 
of strong mustard water, in addition to the above. 



to the feet, and a small fly blister ovet tin- Birth 
een ical \ ertebra, aboul one and one-half incl 
Bquare, and verthapsus in doses of one-fourth (1) 
of a grain for adults, and one-eighth (I) of a grain 
for children, every Bis hours, until its cathartic 
effect is produced, thereby relieving the portal 
circulation— consequently the engorgement of the 
liver, blood vessels and capillaries are relieved, 
thus enabling the liver to resume its normal func- 
tions again. 

The natural tendency, or in fact the eflfed of the 
poison, or cause, of this disease is to produce dis- 
organization of the blood. Consequently from the 
known medical properties of this antidote I used 
it fnvly for the purpose and expectation of pre- 
venting such a deleterious effect upon this vital 
element (blood) of our bodies, which is sure to take 
place in severe cases, unless prevented by this or 
some other remedy. And from my experience of 
its use in this disease, and knowledge of its prop- 
erties, I believe it to be better calculated to fulfill 
this purpose than any other. 

In order to make the treatment more plain, dis- 
tinct and definite, that we may not be swayed 
hack and forth, trying one remedy and then ano- 
ther — by way of experiment, without any definite 
aim — I will state here what I stated in my remarks 
on the nature of Yellow Fever : — that patients who 
die of Yellow Fever die from one of two causes 
either from disorganization of the blood (the effect 
of the cause or poison), or from congestion. Now, 
if we prevent the former (which can be done by 
the free use of the antidote at the start), and re- 
move or correct the latter— ingestion— (which 



10 

can be done by suitable remedies, such as cathar- 
tics and revulsives), we are then quite certain of 

success. y 

The Formula, or Recipe, is given later on in the 
hook hut may as well also he given here : 

Antiparasitic (5) Five Drams. 

Reparin (.1) Half Dram. 

Saccharine Alba (l) One Ounce. 

Comp. Tr. Cinnamon (1) One Dram. 

Warm Water (1) One Pint. 

Mix. Dose once. 

Manner of taking it in the first stages : 

In the administration of the antidote, if the pa- 
tient is an adult allow him to drink one tea-cupful 
of this preparation at one draught, and the balance 
in the course of twelve hours. It is desirable that 
this large amount is taken at the onset of the dis- 
ease to prevent disorganization of the blood, by 
destroying or neutralizing the germs of the dis- 
ease. In order to make certain of this effect the 
system needs to be thoroughly saturated with 
it. A pint of this mixture, or antidote, thus 
prepared, I administered to a little patient, seven 
years old, during the course of twenty-four hours, 
with good effect, as the patient recovered. It is 
important that this article — the antidote — be used 
freely in the first stages of the disease, and then 
diminished gradually as the patient improves. Or 
in other words, give a half teacupful every two or 
three hours during the first two or three days of 
the disease, and thereafter a half teacupful every 
four or six hours may be sufficient during the 
course of the disease. But remember — as impor- 
tant as this remedy may be, to insure success the 
remedies for the relief of the congestion should not 



If 

be overlooked, viz.: revulsives and catharl 
Both points of treatment should be strictlj ob 

rved in every pari icular. 

Mustard should l>o kept over the region of the 
Btomach so long as there is any tendency to nan 
or vomiting, and also over the whole Length of the 
Bpine as long as there is any sensation of coldn< 
The blister, recommended to be applied over the 
sixth cervical vertebra, which is situated or Located 
just above the first dorsal or prominence between 
the shoulders, on the lower pari of the back of the 
neck, is calculated to aid in removing the c<»ld 
sensation along the spine and congestion, by 
arousing the splanich nerves. 

In the course of one or two days, or as soon as 
the bowels have been thoroughly acted upon, and 
the secretions of the liver have been started, a 
tonic should be commenced in the shape of cincho- 
nidia orquinine. If cinchonidia is used, about two 
grains should be given at a dose once in four hours. 
If quinine, but one grain, at the same intervals. 

Calomel, although recommended by some 
authors in large doses, should be avoided or dis- 
carded, as it has a deleterious effect on the blood 
by destroying its fibrin, thereby aiding in pro- 
ducing its disorganization, which, in our treat- 
ment we are endeavoring to prevent. 

A good pill to use in the first stages of the dis- 
ease, for the cathartic, is verthapsus, aloine and 
extract of traxicum. Say, verthapsus, 6 grains; 
aloine (not crude aloes), one-half of a grain ; ex- 
tract of traxicum, 12 grains ; well mixed and made 
into twenty-four pills, each pill containing one- 
fourth of a grain of verthapsus, one forty-eighth 



12 

of a grain of aloine, and one-half a grain of traxi- 
cum. ( toe pill is to be given every six hours until 
the bowels have been freely acted upon. After 
the free action of the bowels has been obtained, 
then one pill night and morning will be sufficient 
to keep the bowels open : if not, take 1 oftener. A 
free action of the bowels does not weaken as it 
does in many other diseases, for the patient gen- 
erally feels stronger and better after an action. 
But if there is hemorrhage from the bowels, as it 
sometimes occurs in the latter stages of the dis- 
ease, one pill at night will be sufficient, and de- 
pend upon the antidote mixture, given quite free- 
ly, for the control of the bloody discharges. That 
is the result of disorganization in the latter stages, 
as is also the black vomit ; but the black vomit in 
the first stages is from congestion. 

( )piates should be avoided in any form (especially 
in the first stages) because they serve to check the 
secretions of the liver and bowels, as well as pro- 
duce and increase the congestion and irritation of 
the brain. If any medicine is required to produce 
sleep, bromides are best — say bromide of potassium 
in doses of fifteen to twenty grains each. 

Stimulants may be useful in the latter stages of 
the disease, after the secretions are fully started, 
but in the first stages, it being necessary to give 
the antidote mixture in such large doses, it seems 
to serve as sufficient stimulant without the aid of 
any other, the skin becoming moist soon after it is 
taken, and a peculiar sense of stimulation is felt 
all over the body and its extremities. 

YELLOWNESS OF THE SKIN. 

To remove the yellowness of the skin that is a 
usual concomitant of this disease, the following 
mixture has proved successful : 

Bi-Chloride of Mercury (1) One Grain. 

Sulphate of Strychnia (1) One Grain. 

Alcohol (2) Drams, or i oz. 

Water (4) Four Ounces. 

Well Mixed. 



Dose. One teaspoonful every six hours, to be 
taken after meals. 

This medicine antidote mixture is a propha 
lactic, and is not only good ;is a cure for Yellow 
Fever, bul is a good prophalactic or preventative 
to the disease. Wherever I had a patienl in a 
family I always recommended thai other member 
<>f the family or household should take about one 
tablespoonful of the antidote mixture once or twice 
a day, as a preventative. It is also one of I he besl 
of remedies in the cure and prevention of \\'\<y . 
and. in fact, all malignant forms of disease and 
hemorrhage. 

Further in regard to the Beneficial Effe< 
of the Antidote Mixture. 

I would say that the blood in the liver and capil- 
laries in this disease is retarded in its circulation 
by its tendency to coagulation, and aside from the 
neutralizing effects of the antidote mixture the 
i'vi^r circulation of the blood in the liver is aided by 
its solvent effects on the blood generally, and its 
function in consequence is thereby restored, en- 
abling the liver to perform its normal action again. 

There need be no fears entertained in using the 
antidote mixture in large doses as recommended. 
I used it in thirty-one cases with no harm, hut al- 
ways with benefit. I would also suggest that a 
good supply of this remedy be kept on hand 
ready for use. in all seasons when fevers pre- 
vail in an epidemic form. It is not only the 
host remedy in cases of Yellow Fever, in breaking 
up and curing the disease, but is suitable and ef- 
fective in the cure of all other forms of fever that 
prevail, whether hemorrhagic or otherwise. I 
would also add that it is effective in the cure and 
treatment of dysentery. 

I will now give the prescription, or formulae, for 
each prescription and directions for use. in connec- 
tion one after the other. 

The First (No. 1). — The antidote t<>. or neutral- 
izer of, the Yellow Fever Poison. 



14 

Yellow Fever Antidote, or Neutralizer. 

Anti Parasitic (5) Five Drams 

Reparin (2) Two Scruples. 

Comp. Tr. Cinnamon (1) One Drain. 

Saccnarine Alba (1) One Ounce, 

Warm Water (1) One Pint, 

Mix. Dose. — In case of Yellow Fever ; to com- 
mence with, four ounces, or about one teacupful. 
should be given in one draught. After four hours, 
three tablespoonfuls should be given every two 
hours (in connection with other remedies used), 
till after the third day : then to be given every 
four or six hours, in two-tablespoonful doses, ac- 
cording to the condition of the patient, through the 
course of the disease. One-half doses to children 
ten to twelve years of age, smaller children in 
proportion. 

The antidote is also useful as a prophylactic, to 
prevent the disease, and also in the prevention and 
treatment of other low forms of fever, whether 
there is hemorrhage or not, as well as in dys- 
entary ; but in these affections, the dose required 
is not so large, say one table spoonful every four 
hours, or six hours, except in dysentary, then the 
dose should be one table spoonful every two hours. 
The next important prescription or formula? — 
which is to be given in connection with the anti- 
dote mixture — is the following: 

Verthapsus (0) Six Grains. 

Aloine (not crude Aloes) . . . (-*) One-half Grain. 

Extract of Traxicum (12) Grains. 

Mix. Made into 24 Pills. 
Dose. — One pill every six hours for adults, chil- 
dren, one-third to one-half a pill, until the bowels 
are acted upon freely — after that give enough to 
keep bowels open, one pill at night — one night and 
morning if necessary to keep bowels open. This 
pill is good in the commencement of all billious 
affections, as well as in Yellow Fever, to break up 
the disease. Given in about the same dose and fre- 
quency as in Yellow Fever. 



18 

The n<wt is the quinine, or cinchonidia, \u one 
or two grain doses, after the second or t bird daj 
after the bowels have been freely acted upon 
once in four hours to adults, children in proportion. 

As heretofore stated, I treated thirty-one ca 
in Jacksonville, Fla., without one death. Bui 
finally, after practicing amidsl the disease for 
about two and one-half months. I had it myself, 
1 became careless and neglected to take the anti- 
dote as a prophylactic, and besides I sat up parts 
(){ two nights with a patient who had the disease 
and was delirious. Having acquired the reputation 
of curing every case [did not want to lose him, sol 
exposed myself and took the disease: hut cured 
myself by taking the same medicines and follow- 
ing the same plan recommended in this hook. I 
did not call in any other physician, for they 
treated the disease in a different way from what I 
did, and lost all ; and I know I would have died 
too if I had depended on anyone else. 

In conclusion, I would say. that it is important 
to keep a good supply of medicine for the treat- 
ment and cure of the disease (Yellow Fever) on 
hand, that you may be prepared should the disease 
break out among you or show itself in your midst — 
you know not the day nor hour. Use all sanitary 
means or precautions to prevent the disease, hut 
do not delay in procuring the medicines as recom- 
mended. Write out the prescriptions as printed 
in this hook, and send said prescriptions to me, 
and I will forward to you the required medicines 
(the pills and the antidote) with full directions 
by mail, prepaid, on the receipt of $3.00. 

Or, if you request me to send a sufficienl 
amount of the medicine to treat one case, (even 
without the prescriptions) 1 will send you three 
prescriptions of the Yellow Fever Antidote or 
neutralize^ put up dry, in three separate bottles. 
This amount being required for the treatment ^\' 
one c.ise — one pint of warm water to he added to 
each bottle of the antidote, as you may need to 



L6 

use it : one box of liver and cathartic pills ; one 
box of quinine, in capsules of one grain each, 30 
in number, as a tonic • a fly blister to be applied 
over the sixth cervical vertebrae on the back of 
the neck. All of the above sent on receipt of 
$3.00, with full directions in accordance with those 
already mentioned in the book. 

Yellow Fever naturally runs a course or type of 
seven days, ending on the eighth day, when prop- 
erly treated. An observation I have never hith- 
erto seen noticed by any author, and if the medi- 
cines are given as recommended in this book, and 
the instructions fully carried out, (which can be 
done by any intelligent person, medical or not), 
you will notice a marked change on the eighth 
day for the better, the disease having run its type 
or course, requiring then only tonics and nour- 
ishments to complete the convalesence or cure, 
if the bowels have been sufficiently acted upon 
to have relieved the congestion, and a sufficient 
amount of the antidote taken to prevent blood 
disorganization. 

To insure prompt attention, address all commu- 
nications and remittances to 

S. P. UHLEIN, M. D., 
Lock Box 52, Starke, Bradford Co. , Fla. 



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